Home-care providers brace for ‘dam bursting’ influx of patients as hospitals catch up on surgeries
Home-care providers are sounding the alarm about a staffing shortage which they say is part of what's causing the ongoing influx of patients in hospitals, including in Hamilton.
Home Care Ontario is concerned about rising demand as hospitals work through an estimated provincial backlog of 419,000 surgeries, while battling both COVID-19 and flu season.
We're on the precipice," said CEO Sue VanderBent. There's just going to be a dam bursting of people who want surgery and want to get care.
And then there's another dam that's going to burst, which is every one of those people is going to need home care."
Home Care Ontario says they've lost 3,000 nurses and countless more" personal support workers (PSWs) since the pandemic began. As a result, the Hamilton-based group of Ontario care providers launched a campaign asking for $600 million to be spent urgently to hire 3,810 nurses, PSWs and other staff to treat existing patients and prepare for an influx of patients receiving surgery.
In Hamilton, St. Joseph's Home Care is down more than 20 per cent of its baseline of 70 nurses, including some part-time and casual staff. After seeing a decline in staffing in summer 2020, the provider has been steadily working at a deficit" for about a year, said president Carolyn Gosse. Some retired early due to burnout, others left the profession for other health-care jobs with higher pay.
She says it's going to be a real challenge" for home care to keep up with the rising demand of surgery in hospitals.
As of August, the acceptance rate for nursing visits for Hamilton-Niagara-Haldimand-Brant home and community care was at 49 per cent, said Home Care Ontario. That means only five out of 10 people asking for nursing care were getting it - a rate that was among the lowest in the province, where the number was 60 per cent overall.
Before the pandemic, a home-care agency was expected to accept referrals 95 per cent of the time, according to a Home Care Ontario release.
A care co-ordinator for Hamilton-Niagara-Haldimand-Brant home and community care said the past six months have been worse than ever" in terms of staffing. The worker, who asked not to be named because she'd been warned by her employer against speaking out, said an area hospice reached out this week asking for nursing help. A patient in palliative care needed pain medication, but no one was available to respond. So, the hospice had to step in.
It's really frustrating," the worker said, noting a similar incident occurred several weeks ago and the patient wound up in hospital. You're dealing with sick people who need help and you can't help them."
The co-ordinator said there are concerns the shortages will soon affect physiotherapists and occupational therapists, too.
The warnings come at a time when Hamilton emergency rooms are seeing record numbers of patients and hospital beds are filling up - partly due to home-care shortages, VanderBent says.
People have been putting up with a wound that's not healing or ignoring pain in their abdomen that is starting to get more concerning (or) they got an infection that's getting worse," she said.
On the flip side, some hospital patients who need support at home may be waiting longer for discharge, said Gosse, who's also VP of integrated care at St. Joseph's Health System. In other cases, people ended up in the emergency department or admitted to hospital because they couldn't get home care in time, though Gosse couldn't share details because of privacy.
The shortage of PSWs, who help with daily activities such as bathing and meals, means family caregivers may have to fill gaps in care while waiting for a worker to become available.
Gosse and VanderBent say one of the ways to alleviate the issue is for the province to address the wage disparities between home care, and hospitals and long-term care.
Home-care teams should be compensated for the complex, highly skilled" care they provide patients as hospital stays continue to shorten, Gosse said.
We are equal to acute care, we are equal to long-term care," VanderBent said. We should be a third leg of the stool and we are not being seen that way."
Maria Iqbal is a Hamilton-based reporter at The Spectator covering aging. Reach her via email: miqbal@thespec.com.